Long-Term Outcomes of Intestinal and Multivisceral Transplantation at a Single Center in Argentina

Ramisch, Diego; Rumbo, Carolina; Echevarria, Constanza; Moulin, L.; Niveyro, Silvia; Orce, Guillermo; Crivelli, Adriana; Martínez, M.; Chávez, L.L. Rivera; Páez, María Alejandra Correa; Trentadue, Julio; Klein, Francisco; Fernández, Adriana; Solar, Héctor; Gondolesi, Gabriel

doi:10.1016/j.transproceed.2015.12.066

Cited by 26 publications

(6 citation statements)

References 40 publications

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“…Ramisch et al (15) reported 3 early (first postoperative week) cases of mortality out of 42 patients (7%) in their study. They worked on primarily long term outcomes.…”

Section: Discussionmentioning

confidence: 82%

The effect of perioperative electrolyte, acid-base balance, hemodynamic data and anesthetic management on early mortality of patients with small bowel transplantation

Güntürk¹,

Aydin²,

Karaman³

et al. 2018

Terh

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Objective: Due to high mortality rates, small bowel transplantation is a rarely applied intervention. In this study, we aimed to investigate the effects of perioperative hemodynamic data, electrolyte balance and blood gas parameters on early period mortality of the patients who underwent small bowel transplantation. Methods: The data of 23 patients, who had undergone small bowel transplantation in our clinic between 2004 and 2016, were examined retrospectively. All the patients' demographic data, causes of small bowel syndrome, perioperative hemodynamic data, electrolyte and blood gas values, blood replacement and early postoperative mortality rates within 48 hours were recorded. Statistical analysis was used to identify the parameters that effected early mortality. Results: The mean age of the 23 patients (13 female, and 10 male) was 34.54±15.2 years. Early period mortality was identified in four patients. When comparing demographic and clinic data with mortality, no statistically significant difference was found. There was a significant difference in pH, HCO3, BE values before and after reperfusion. No significant difference was found between electrolyte, blood gas values and early period mortality in the comparison of the same data. Conclusion: Many variables effect mortality in small bowel transplantation patients. We think that hemodynamic and metabolic changes should be monitored carefully in perioperative period to avoid early period mortality. ÖZ Amaç:Yüksek mortalite oranları nedeniyle ince bağırsak transplantasyonu oldukça nadir olarak uygulanan bir girişimdir. Bu çalışmada, ince barsak transplantasyonu uygulanan olguların peroperatif dönemdeki hemodinamik verilerini, elektrolit yönetimini, kan gazı değerlerinin erken dönem mortalite üzerine etkilerini araştırmayı amaçladık. Yöntem: 2004-2016 yılları arasında hastanemiz kliniğimizde ince barsak transplantasyonu operasyonu yapılmış olan 23 hastanın verileri retrospektif olarak incelendi. Tüm hastaların demografik verileri, kısa bağırsak sendromu nedenleri, peroperatif hemodinamik verileri, kan gazı değerleri, kan replasmanı ve postoperatif ilk 48 saat erken dönem mortalite oranları kaydedildi. Mortaliteyi etkileyen parametreleri tanımlamak için istatistiksel analiz yapıldı. Bulgular: Hastaların yaş ortalaması 34,54±15,2 olup, 13'ü kadın, 10'u erkek hastaydı. Erken dönem mortalite toplam 4 hastada gerçekleşti. Mortalite ile demografik ve klinik veriler karşılaştırıldığında istatistiksel olarak fark saptanmadı. Kan gazı ve elektrolit değerlerinin reperfüzyon öncesi ve sonrası karşılaştırılmasında sodyum, pH, HCO3, BE değerleri arasında anlamlı fark vardı. Aynı veriler erken dönem mortalite ile karşılaştırıldığında ise istatistiksel olarak anlamlı fark saptanmadı. Sonuç: İnce bağırsak transplantasyonu yapılan hastalarda mortalite üzerinde birçok değişken mevcuttur. Erken dönem mortaliteyi azaltmak açısından peroperatif dönemde hemodinamik ve metabolik değişikliklerin dikkatle izlenmesi gerektiğini düşünmekteyiz.

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“…Ramisch et al (15) reported 3 early (first postoperative week) cases of mortality out of 42 patients (7%) in their study. They worked on primarily long term outcomes.…”

Section: Discussionmentioning

confidence: 82%

The effect of perioperative electrolyte, acid-base balance, hemodynamic data and anesthetic management on early mortality of patients with small bowel transplantation

Güntürk¹,

Aydin²,

Karaman³

et al. 2018

Terh

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“…In cases of intestinal transit problems, the “chimney” could act as a safety vent, partially decompressing the anastomosis and reducing the risk of anastomotic breakdown. Due to its advantages, it has gradually been adapted for many other purposes, such as jejunoileal atresia, NEC, short bowel syndromes, and even intestinal transplantation 5 , 21 , 23 , 24 , 26 .…”

Section: Discussionmentioning

confidence: 99%

Bishop-Koop Ostomy Revisited: A “Test-Drive” Intestinal Diversion for Children With Suspected Bowel Dysmotility

Silva

Miranda

FILHO

et al. 2023

ABCD, arq. bras. cir. dig.

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BACKGROUND: Bishop-Koop ileostomy has been widely used in pediatric patients with the intention of including as much bowel as possible in the intestinal transit early in the management of children with meconium ileus and intestinal atresia. In recent years, we have been using it as an alternative to test the distal bowel function before closure of a previously constructed ostomy in selected children with questionable distal bowel motility. AIMS: The aim of this study was to present our experience with this alternative use of the Bishop-Koop ostomy. METHODS: This is a cross-sectional retrospective review of hospital records, combined with a comprehensive literature review. RESULTS: Seven children were included: five had suspected aganglionosis, one had gastroschisis complicated with ileal atresia, and one had a colonic stricture secondary to necrotizing enterocolitis. In this short series of patients, motility of the distal bowel was correctly assessed in six patients and partially correctly assessed in one patient. One patient did not pass stools per anus after the Bishop-Koop, and he was later confirmed to have Hirschsprung disease. Four patients resumed normal evacuation pattern after closure of the Bishop-Koop. One patient had a Bishop-Koop colostomy because of recurrent enterocolitis after a transanal pull-through. Although he evacuated normally while having the colostomy, the diarrhea recurred after the ostomy was closed. An additional patient, with a severe behavioral problem, did not evacuate per anus after her colostomy was transformed in a Bishop-Koop-type ostomy, despite the apparent presence of normal ganglia in the bowel wall. CONCLUSIONS: Data from the present series allow us to affirm that Bishop-Koop-type ostomy is a safe and efficient procedure that can be used to assess distal bowel function before a definitive transit reconstruction, in children with uncertain motility issues.

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“…La Argentina es el país de la región con más experiencia en trasplante de intestino y multivisceral, y cuenta con dos programas de trasplante activos (Hospital Universitario Fundación Favaloro y Hospital Italiano de Buenos Aires). [11][12] Con las limitaciones expuestas, tanto para el acceso a la NP domiciliaria como al trasplante de intestino, el concepto de rehabilitación intestinal fue incorporándose, entendido como el conjunto de medidas médico-quirúrgicas-nutricionales orientadas a recuperar la suficiencia intestinal. [13][14][15][16][17] En los últimos años, el avance en la rehabilitación médico-quirúrgica a través del desarrollo de técnicas de cirugía de rehabilitación intestinal, [18][19][20][21] pero fundamentalmente debido a la introducción del uso de enterohormonas en el tratamiento médico, ha cambiado el curso de esta patología y permitido la rehabilitación intestinal en pacientes con longitudes y anatomías intestinales poco favorables.…”

Section: Introductionunclassified

Teduglutida en pacientes adultos con falla intestinal crónica por síndrome de intestino corto: protocolo de manejo con base en recomendaciones de expertos

Solar

Crivelli²,

Barrio³

et al. 2022

Acta gastroenterol. latinoam.

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Chronic intestinal failure due to short bowel syndrome is a severe and complex disease that requires a specialized multidisciplinary treatment. Parenteral nutrition is the fundamental support in these patients; however, in the long term, complications associated with it may develop that contraindicate its continuity. In this context, an isolated or combined intestinal transplant (liver-intestine) is the last alternative to recover intestinal sufficiency. Since 2012 was introduced in the world, the use of semisynthetic GLP2 peptide, called teduglutide, changed the course and prognosis of this disease. Argentina is the Latin American country with the most experience in the use of this enterohormone, with results comparable to those of other international centers. This article summarizes the expert recommendations for the use of teduglutide in patients with chronic intestinal failure due to short bowel syndrome.

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Long-Term Outcomes of Intestinal and Multivisceral Transplantation at a Single Center in Argentina

Cited by 26 publications

References 40 publications

The effect of perioperative electrolyte, acid-base balance, hemodynamic data and anesthetic management on early mortality of patients with small bowel transplantation

The effect of perioperative electrolyte, acid-base balance, hemodynamic data and anesthetic management on early mortality of patients with small bowel transplantation

Bishop-Koop Ostomy Revisited: A “Test-Drive” Intestinal Diversion for Children With Suspected Bowel Dysmotility

Teduglutida en pacientes adultos con falla intestinal crónica por síndrome de intestino corto: protocolo de manejo con base en recomendaciones de expertos

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